Encephalitis Japanese

of EEE were reported in horses and only five humans contracted the disease.

In addition to eastern equine encephalitis and western equine encephalomyelitis, there is a third type: Venezuelan equine encephalitis. Eastern equine encephalitis is a severe form of equine encephalitis; it lasts longer and causes more deaths and problems than either the western or Venezuelan versions. Venezuelan equine encephalitis occurs in Central and South America, Florida, and Texas.

Cause Four different types of mosquitoes carry the virus responsible for EEE. The virus enters the bloodstream through the mosquito bite, traveling directly to the spinal cord and brain. As the virus multiplies in the central nervous system, it damages the nerve cells, interfering with the signals the brain sends to the body.

Despite its name, the primary natural hosts of the viruses of eastern and western equine encephalitis are birds, not horses.

Because the virus is not present in the blood of humans, it is not transmitted between people. People who live in areas where the mosquito carries the virus are immune, since they were bitten as children and developed antibodies without ever becoming sick. Since the disease is transmitted primarily by mosquitoes, it occurs most often during the insect season, especially in low marshy areas.

Symptoms Unlike St. Louis encephalitis (see encephalitis, st. louis) in which only a few patients have symptoms, most people with EEE get symptoms, which begin 5 to 15 days after a mosquito bite. Symptoms begin with headache, fever, chills, muscle aches, and nausea, followed by paralysis, convulsions, and coma.

In humans, the elderly are most at risk for serious cases; almost 80 percent of older patients die. Infants and young children are also at risk. Those who are sick for a few days before the paralysis and convulsions appear will probably recover completely. Chances for a complete recovery without any permanent damage are best in adults over 40 and under 80.

Signs of the disease in horses include fever, loss of appetite, discomfort, mental deterioration, head pressing, circling, and blindness. Death occurs two to three days after infection, caused by the sudden inability to breathe.

Diagnosis Rapid tests to identify antibodies to the EEE virus in blood and cerebrospinal fluid are now available.

Treatment There is no cure for encephalitis. Pain medication for fever and headache may be given.

Complications Long-term damage may include facial palsy, weakness, seizures, or mental problems such as confusion and hallucinations. Children younger than five have a poor outlook for recovery.

Prevention A vaccine can prevent the disease in horses and should be given in areas where EEE is prevalent. All foals must be vaccinated, and older horses must be re-vaccinated during the EEE season. An experimental vaccine is available for those who work in labs with the virus.

encephalitis, Japanese A mosquito-borne version of encephalitis that is primarily a rural disease of the Orient and does not occur in the United States. It is found primarily in China and Korea, India, Bangladesh, Nepal and Sri Lanka, and southeast Asian countries. It occurs less often in Japan, Taiwan, Singapore, Hong Kong, and eastern Russia. It is the leading cause of viral encephalitis in Asia.

Japanese encephalitis is a zoonosis a disease that primarily infects animals but sometimes moves into the human population. It belongs to a group of viruses called flavivirus (which includes St. Louis encephalitis). See encephalitis, st. louis.

The chance that a U.S. traveler to Asia will contract the disease is small; only 11 cases among Americans traveling or working in

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